Socio-demographic Characteristics of Respondents
A total of 360 clients participated in the study. By sex, 105 males and 255 females were interviewed with the mean age of 61.9 (± 10.7) with ages ranging from 27 to 94 years. More than half of the respondents were aged over 61years. Respondents were mostly married, and few had attained tertiary education (4.7%) (Table 1).
Table 1: Socio-demographic characteristics of respondents
|
Characteristic
|
Frequency
(n=360)
|
Relative Frequency
(%)
|
Sex
|
|
|
Male
|
105
|
29.17
|
Female
|
255
|
70.83
|
|
|
|
Age
|
|
|
Mean age (± SD)
|
61.9
|
10.7
|
27-45
|
19
|
5.28
|
46-60
|
142
|
39.44
|
61-94
|
199
|
55.28
|
|
|
|
Marital Status
|
|
|
Single
|
20
|
5.56
|
Married
|
243
|
67.50
|
Divorced
|
20
|
5.56
|
Widowed
|
77
|
21.39
|
|
|
|
Educational Status
|
|
|
No formal education
|
92
|
25.56
|
Primary
|
109
|
30.28
|
Junior high
|
85
|
23.61
|
Secondary
|
57
|
15.83
|
Tertiary
|
17
|
4.72
|
|
|
|
Income(US $ )
|
|
|
Less than $40
|
209
|
58.06
|
$40- $120
|
112
|
31.11
|
$120-$210
|
30
|
8.33
|
>$210
|
9
|
2.50
|
|
|
|
Respondents’ knowledge about hypertension
Approximately 73.3% of respondents showed poor knowledge of hypertension, 25.6% showed moderate knowledge and only 1.1% showed good knowledge of hypertension (Results not shown).
Reasons for missing medication among respondents
Table 2 presents the reported reasons for missed medication among the respondents. The majority (70.5%) cited forgetfulness as the reason for missing their medication. Another reason that was prominently cited was the high pill burden.
Table 2: Reasons for missed medication among respondents (n=291a)
Reason
|
Frequency
|
Percentage
|
Forgetfulness
|
205
|
70.45
|
High pill burden
|
78
|
26.80
|
Side effects of medication
|
69
|
23.71
|
Cost of medication
|
12
|
4.12
|
Does not believe in orthodox medicines
|
16
|
5.50
|
Believed was cured
|
9
|
3.09
|
Believe in divine intervention
|
1
|
0.34
|
a Available for 291 participants who responded to reason for missing medication
Hypertension control among respondents
In total, less than a third of clients had achieved hypertension control (23.3%). Various socio-demographic characteristics were assessed against hypertension control. By sex, among female respondents, 69 (27.1%) had achieved hypertension control and 15 (14.3%) of male respondents had achieved hypertension control. This association was found to be significant (p<0.009). Table 3 contains further details on hypertension control across various socio-demographic factors.
Table 3: Socio-demographic factors and Hypertension control
Variable
|
Controlled BP
|
|
|
|
No
|
Yes
|
χ2
|
p-value
|
|
n (%)
|
n (%)
|
|
|
Age
|
|
|
|
|
Mean age (± SD)
|
61.86±0.56
|
|
|
0.012
|
|
|
|
|
|
Age categories
|
|
|
|
|
27-45
|
15(78.95)
|
4(21.05)
|
0.7991
|
0.671
|
46-60
|
112(78.87)
|
30(21.13)
|
|
|
61-94
|
149(74.87)
|
50(25.13)
|
|
|
Sex
|
|
|
|
|
Male
|
90(85.71)
|
15(14.29)
|
6.7832
|
0.009
|
Female
|
186(72.94)
|
69(27.06)
|
|
|
|
|
|
|
|
Marital Status
|
|
|
|
|
Single
|
15(75.00)
|
5(25.00)
|
5.9367
|
0.115
|
Married
|
195(80.25)
|
48(19.75)
|
|
|
Divorced
|
13(65.00)
|
7(35.00)
|
|
|
Widowed
|
53(68.83)
|
24(31.17)
|
|
|
|
|
|
|
|
Educational Status
|
|
|
|
|
No formal education
|
74(80.43)
|
18(19.57)
|
8.4273
|
0.077
|
Primary
|
90(82.57)
|
19(17.43)
|
|
|
Junior high
|
56(65.88)
|
29(34.12)
|
|
|
Secondary
|
43(75.44)
|
14(24.56)
|
|
|
Tertiary
|
13(76.47)
|
4(23.53)
|
|
|
|
|
|
|
|
Income
|
|
|
|
|
Less than $40
|
163(77.99)
|
46(22.01)
|
1.8755
|
0.599
|
$40- $120
|
84(75.00)
|
28(25.00)
|
|
|
$120-$200
|
21(70.00)
|
9(30.00)
|
|
|
>$200
|
8(88.89)
|
1(11.11)
|
|
|
Total
|
276 (76.67)
|
84 (23.33)
|
|
|
n: Frequencies, %:row percentages.
Associations between client factors and hypertension control
Assessing patients by comorbidity showed that 18% of patients who had no comorbidities had achieved hypertension control. However, more patients with some comorbidity had achieved hypertension control (23.3%). Among patients with dyslipidaemia, 8.9% had controlled hypertension (p<0.006). Table 4 has further details of factors associated with hypertension control.
Table 4 Associations between other client factors and hypertension control
Variable
|
Controlled BP
|
|
|
|
No
|
Yes
|
χ2
|
p-value
|
|
n(%)
|
n(%)
|
|
|
Comorbidity
|
|
|
|
|
No
|
217(81.89)
|
48(18.11)
|
15.2969
|
<0.001
|
Yes
|
59(62.11)
|
36(23.33)
|
|
|
Diabetes
|
|
|
|
|
No
|
147(74.62)
|
50(25.38)
|
1.0195
|
0.313
|
Yes
|
129(79.14)
|
34(20.86)
|
|
|
CKD
|
|
|
|
|
No
|
262(75.72)
|
84(24.28)
|
|
0.047+
|
Yes
|
14(100.00)
|
0(0.00)
|
|
|
Dyslipidaemia
|
|
|
|
|
No
|
225(74.01)
|
79(25.99)
|
7.6921
|
0.006
|
Yes
|
51(91.07)
|
5(8.93)
|
|
|
Stroke
|
|
|
|
|
No
|
262(76.83)
|
79(23.17)
|
0.0997
|
0.752
|
Yes
|
14(73.68)
|
5(26.32)
|
|
|
Pills taken for comorbidity
|
1-2
|
84(80.77)
|
20(19.23)
|
|
0.725+
|
3-6
|
130(83.87)
|
25(16.13)
|
|
|
7-13
|
3(75.00)
|
1(25.00)
|
|
|
Non-Prescribed Medb.
|
|
|
|
|
No
|
209(76.56)
|
64(23.44)
|
0.0076
|
0.930
|
Yes
|
67(77.67)
|
20(22.99)
|
|
|
|
|
|
|
|
Total
|
276 (76.67)
|
84 (23.33)
|
|
|
|
|
|
|
|
|
|
|
|
n: Frequencies ,%:row percentages.
a Co-morbidity was defined as the presence of diabetes, chronic kidney disease or dyslipidaemia.
bNon prescribed medication refers to any drug the client is currently taking that is not prescribed by the attending physician
+ Fishers’ exact value
Determinants of hypertension control
Table 5 shows the determinants of hypertension control among clients. Females were 3.13 times more likely to have their BPs controlled compared to men [AOR=3.13(95% CI 1.48-6.62)]. A 70% reduction in the odds of having controlled hypertension was identified among patients who suffered from dyslipidaemia as comorbidity, compared to those who did not suffer this comorbidity [AOR=0.27 (95% CI 0.09, 0.84)].
Taking a higher number of antihypertensive pills per day was also associated with a reduced likelihood of attaining hypertension control. Given that a respondent took 3-4 antihypertensive pills per day, the odds of having a controlled BP was reduced by 58% [AOR=0.42 (95% CI 0.23, 0.77)] compared to those who took 1 to 2 pills. (Table 5).
Table 5: Socio-demographic determinants of hypertension control among respondents
Characteristic
|
UOR [95% CI]
|
AOR a [95% CI]
|
Age
|
1.03[1.00-1.05]
|
|
27-45
|
Ref
|
|
46-60
|
1.00 [0.31- 3.25]
|
1.41[0.38-5.33]
|
61-94
|
1.25[0.40-3.97]
|
1.45 [0.38-5.54]
|
Sex
|
|
|
Male
|
Ref
|
Ref
|
Female
|
2.23[1.21-4.11]*
|
3.33[1.63-6.80]**
|
Education
|
|
|
No formal Education
|
Ref
|
Ref
|
Primary
|
0.88[0.42-1.77]
|
1.32[0.59-2.93]
|
Junior High
|
2.13[1.08-4.21]*
|
2.93[1.36-6.33]*
|
Secondary
|
1.34[0.61-2.96]
|
2.51[1.01-6.24]*
|
Tertiary
|
1.27[0.37-4.34]
|
1.84[0.47-7.12]
|
Length of diagnosis (years)
|
|
|
1
|
Ref
|
Ref
|
2 - 5
|
0.33[0.14-0.77]*
|
0.63[0.19-2.08]
|
6 - 10
|
0.48[0.21-1.11]
|
0.88[0.26-2.93]
|
11- 40
|
0.88[0.37-2.05]
|
1.12[0.34-4.08]
|
Comorbidity
|
|
|
No comorbidity
|
Ref
|
Ref
|
Comorbidity present
|
2.76[1.64-4.64]*
|
2.66[1.46-4. 83]**
|
Dyslipidaemia
|
|
|
Not present
|
Ref
|
Ref
|
Present
|
0.28[0.11-0.72]**
|
0.30[0.10-0.85]*
|
Stroke
|
|
|
Not present
|
Ref
|
Ref
|
Present
|
1.18[0.41-3.34]
|
1.82[0.54-6.06]
|
No. BP pills taken per day
|
|
|
1-2 pills
|
Ref
|
Ref
|
3-4 pills
|
0.37[0.22-0.61]***
|
0.33[0.19-0.56]**
|
|
|
|
UOR: Unadjusted odds ratio a Adjusted for all items in the table
AOR: Adjusted odds ratio * p < 0.05; ** p < 0.01; ***p < 0.001